CGF Treatment of Leg Ulcers: a Randomized Controlled Trial

Novel Applications of Concentrated Growth Factors in Facial Rejuvenation and Plastic Surgery

Concentrated growth factor (CGF), which is a third-generation platelet concentrate product, exhibits good potential for repair and regeneration of soft and hard tissues, and has gradually attracted attention in the field of cosmetic plastic surgery. The purpose of this review is to summarize the application and research of CGF in the field of facial rejuvenation and plastic surgery. A comprehensive review of the literature about the applications of CGF in facial rejuvenation and plastic surgery was conducted in PubMed, Ovid MEDLINE, and Web of Science. According to the inclusion and exclusion criteria, a total of 22 articles were included in this review. In recent years, CGF has been applied in many aspects in the field of facial rejuvenation and plastic surgery, including skin photoaging, repairment of soft-tissue defects, rhinoplasty, hair loss, autologous fat transplantation, and scars. In addition, no significant adverse reactions have been reported so far. CGF is rich in high-concentration growth factors, which has great potential and application prospects in facial rejuvenation and plastic surgery. However, the applications of CGF still have some problems, such as the mechanism, time of decomposition, and long-term efficacy and safety, which are needed to be resolved in future.

Assessing the Efficacy of Laser Therapy and Autologous Platelet-Rich Plasma (PRP) Treatment for Chronic Wounds

(1) Background: The management of persistent wounds is a topic of significant concern, particularly when they become chronic. Clinicians are focused on reducing the healing duration of chronic wounds and employing the most efficient treatments. Successful wound management requires an understanding of standard healing processes, the elements that can impede healing progress, and strategies to manage these impediments. (2) Methods: We participated in a study involving a cohort of 115 patients. Data were collected through subjective assessments via questionnaires, examining the comparative effects of laser therapy and platelet-rich plasma (PRP) on patients' conditions and monitored the progression of chronic wounds. For the study, we utilized a branded laser equipped with a 12-watt probe to stimulate chronic wounds in 65 patients, while the PRP procedure was administered to 50 patients. (3) Results: We observed a greater improvement in local symptoms among the patients who received laser therapy compared to those in the PRP group. (4) Conclusions: We consider both therapies to be of significant importance due to their positive and beneficial effects, particularly on the symptomatology and progression of chronic wounds. Nevertheless, superior results were documented in patients who underwent laser therapy.

Platelet-Rich Plasma in Chronic Wound Management: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

BACKGROUND

Chronic wounds place a heavy burden on the healthcare system due to the prolonged, continuous need for human resources for wound management. Our aim was to investigate the therapeutic effects of platelet-rich plasma on the treatment of chronic wounds.

METHODS

The systematic literature search was performed in four databases. Randomized clinical trials reporting on patients with chronic wounds treated with platelet-rich plasma (PRP) were included, comparing PRP with conventional ulcer therapy. We pooled the data using the random effects model. Our primary outcome was the change in wound size.

RESULTS

Our systematic search provided 2688 articles, and we identified 48 eligible studies after the selection and citation search. Thirty-three study groups of 29 RCTs with a total of 2198 wounds showed that the odds for complete closure were significantly higher in the PRP group than in the control group (OR = 5.32; CI: 3.37; 8.40; I² = 58%).

CONCLUSIONS

PRP is a safe and effective modality to enhance wound healing. By implementing it in clinical practice, platelet-rich plasma could become a widely used, valuable tool as it could not only improve patients' quality of life but also decrease the healthcare burden of wound management.

Mercury and Mercury-Containing Preparations: History of Use, Clinical Applications, Pharmacology, Toxicology, and Pharmacokinetics in Traditional Chinese Medicine

Historically, mercury and mercury-containing preparations have been widely used in traditional Chinese medicine and applied in many clinical practices mainly in the form of mercury sulfides. The clinical application, toxicity manifestations, and symptoms of these preparations largely depend on the route of administration and the dosage form. Commonly used mercury-containing medicinal materials and preparations in traditional Chinese medicine include Cinnabar, an excellent medicine for tranquilizing the nerves; Hongsheng Dan and Baijiang Dan, which have antibacterial, anti-inflammatory, promotion of tissue repair and regeneration and other pharmacological effects. Tibetan medicine commonly uses Zaotai and Qishiwei Zhenzhu pills, which have pharmacological effects such as sedation, anti-inflammatory, anti-convulsant, and improvement of cerebral apoplexy. Menggen Wusu Shibawei pills, commonly used in Mongolian traditional medicine, have the muscle growth and astringent effects. In India and Europe, mercury is often used for treating syphilis. This article summarizes the history, clinical application, pharmacology, toxicology, and pharmacokinetics of mercury and mercury-containing preparations in traditional medicines. In terms of clinical application, it provides suggestions for the rational use and safety of mercury-containing drugs in clinical practices and in public health issues. It will further provide a reference for formulation strategies related to mercury risk assessment and management.

Growth factors for treating chronic venous leg ulcers: A systematic review and meta-analysis

Chronic venous leg ulcers (VLU) are wounds that commonly occur due to venous insufficiency. Many growth factors have been introduced over the past two decades to treat VLU. This systematic review and meta-analysis evaluates the impact of growth factor treatments of VLU in comparison to control for complete wound healing, percent reduction in wound area, time to wound healing, and adverse events. A systematic review and meta-analysis of randomised trials was conducted. MEDLINE and EMBASE were searched up to December 2020. Studies were included if they compared a growth factor versus placebo or standard care in patients with VLU. From 1645 articles, 13 trials were included (n = 991). There was a significant difference between any growth factor and placebo in complete wound healing (P = 0.04). Any growth factor compared to placebo significantly increased the likelihood of percent wound reduction by 48.80% (P = <0.00001). There was no difference in overall adverse event rate. Most comparisons have low certainty of evidence according to Grading of Recommendations, Assessment, Development, and Evaluation. This meta-analysis suggests that growth factors have a beneficial effect in complete wound healing of VLU. Growth factors may also increase percent reduction in wound area. The suggestion of benefit for growth factors identified in this review is not a strong one based on the low quality of evidence.

Review of the Current Evidence for Topical Treatment for Venous Leg Ulcers

OBJECTIVE

The development of a venous leg ulcer (VLU) represents the most severe clinical manifestation of a chronic venous disease. Despite major progress, there is a limited understanding of VLU pathogenesis and wound healing biology. Treatment of VLUs remains a serious challenge for physicians of different specialties. This communication focuses on describing the rationale and scientific basis for topical wound care in the management of VLUs.

METHODS

A literature review was performed to summarize methods with proven efficacy in VLU management. A systematic literature search was also performed to identify new evidence from the randomized controlled trials published within 2014-2021. The scientific challenges, clinical practice concerns, economic obstacles, and possible directions for further research have been discussed.

RESULTS

Hundreds of topical products have been advertised for the treatment of VLUs. Published data on topical treatment of venous ulcers is insufficient, scattered, weak, and has significant methodological flaws. Forty-three randomized controlled trials on topical treatment of VLUs have been published within 2014-2021. Clinical practice guidelines need to be updated. Major gaps in knowledge have been identified, and suggestions for future research directions have been provided.

CONCLUSIONS

The American Venous Forum Research Committee would like to bring attention to topical wound care for VLUs as a critical gap in knowledge, and encourage scientists, practitioners, and industry to collaborate to fill this gap.